1. 1 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer Human Research Program (HRP) Increment 18 Overview Increment Coordinator Suzanne McCollum/NASA Increment Lead Stuart Johnston/LM Inc Operations Lead Katie Spicer/LM

2. 2 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer Agenda ISSMP Team Payload Science Complement  ISS Payloads  Shuttle Payloads  Space Flight Participant (SFP) Activities  Facility Support & Activities Assumptions Inc18 Implementation Characteristics Issues/Risks Forward Work Back-Up Slides

3. 3 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer ISSMP/HRF Support Team NASA Increment Coord. Suzanne McCollum 281-483-7307 suzanne.g.mccollum@nasa.gov Increment Lead Stuart Johnston 281-218-3023 stuart.johnston@lmco.com Inc Operations Lead Katie Spicer 281-218-3233 kathryn.m.spicer@lmco.com Increment Scientist Dr. Daniel Feeback 281-483-7189 daniel.l.feeback@nasa.gov Increment Science Coord. Pasha Morshedi 281-218-3178 pasha. morshedi@lmco.com Increment Training Coord. Mike Joseph 281-218-3205 michael.h.joseph@lmco.com

4. 4 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer Inc 18 HRP ISS Payload Complement Nutrition w/ RepositoryNominal14-17  1J FE2, CDR, ULF2 FE2, 15AFE2 Integrated ImmuneNominal16-17  1J FE2, CDR, ULF2 FE2, 15AFE2, 18S FE1 Midodrine Nominal17  1J FE2 BisphosphonatesNominal18  15A FE2 JournalsNominal/Reserve 8-17  1JFE2 – Nom, CDR - Res SleepReserve14-17  1J FE2, CDR, ULF2 FE2, 15A FE2, 18S FE1 CCISSReserve15-16  CDR, ULF2 FE2 * CDR is also participating in Epstein-Barr, a Pre-/Post-flight investigation PayloadStatusIncrements

5. 5 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer Inc 18 HRP Shuttle Complement HST (STS-125)  SDBI 1503 Midodrine Short  SDBI 1634 Sleep Short  DSO 500 Epstein-Barr (Pre-/Post-) ULF2 (STS-126)  SDBI 1900 Integrated Immune  SDBI 1634 Sleep Short  DSO 500 Epstein-Barr (Pre-/Post-) 15A (STS-119)  SDBI 1900 Integrated Immune  SDBI 1634 Sleep Short

6. 6 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer Space Flight Participant 17S SFP will have no time allocation identified in the Ops products. All HRP activities supported will be identified in an I-17/18 OCR. Integrated Immune  SFP Subject will be a short-duration subject  Saliva collections will be taken every other day starting at FD02  Blood Draw will align with CDR and 1J FE2 blood draws  CDR or 1J FE2 will be the Blood Draw Operator  Available supplies will support Saliva and Blood activities Sleep  SFP Subject will be a short-duration subject  Actiwatch initialized prior to arrival on 17S along with CDR Actiwatch  SFP Doff/Stow will be requested through CDR/1J FE2  Sleep Logging will occur everyday using paper logs  Final Actiwatch Download/downlink will occur at the next opportunity by an US ISS Crewmember after SFP Departure Visual Acuity (PRK)  Paper Logs will be used throughout SFP duration

7. 7 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer ISSMP – HRF Facility Supported Investigations CARD – PFS/RC (ESA) SOLO – RC/SLAMMD (ESA) Braslet – Ultrasound (SDTO) Untended GASMAP- will be run every 30-45 days PC UltraBay Change-Outs HRF PC 2 IP Address Reset Holter Monitor 2 Checkout (reserve) CBPD Checkout (reserve) USND Lite (reserve)‏ PEMS-2 Checkout (reserve)‏ GDS Photo (reserve)‏ HRF PC 1 & 2 Downlink (reserve) ISSMP – HRF Facility Activities

8. 8 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer Inc 18 Assumptions HRF Rack 1 and 2 will be located in the Columbus Module and checked out HRF PC1 will be powered via SUP after Rack Move and successful Checkout to permit flexible implementation from Task List Ultrasound Lite (once/increment) will be fulfilled by the SDTO Braslet activity during Inc 18 ULF2 PC Load will occur as soon as possible after arrival on ULF2  Remove Windows log-in  Added Journals and Sleep Log Software  Added folders and file location file for each investigation for Inc 18-Inc 19/20  Added MAC address batch file ANITA will be deactivated and stowed in Inc 17; ANITA will be transferred for return on ULF2 in Inc 18 Stability Kit (4 of 4) will return home on ULF2

9. 9 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer Crewtime includes the following session: 1JFE2 – 1session: FD 180 CDR – 5 sessions: FD 15, 30, 60, 120, 180 ULF2 FE2 – 4 sessions: FD 15, 30, 60, 120 15A FE2 – 2 sessions: FD 15, 30 MELFI stowage optimal temperature -80˚C and highest temp not to exceed -68˚C. Cold stowage return maximum temp -20˚C for passive return or -80˚C or colder for active return MELFI to direct on Dewar location in execution notes N: 53.75 Nutrition w/ Repository 4 1J FE2 CDR ULF2FE2 15A FE2 ISSMP Expedition 18 Inflight Experiments CharacteristicsCrew Time SubjectsExperiment

10. 10 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer New investigation – Objective: to understand if Bisphosphonates may serve as protection against decrease in bone mineral density during spaceflight Nominal time for weekly 15A FE2 pill ingestions (1x/week) All Urine collection sessions are planned to be combined with Nutrition sessions Urine sample is frozen in MELFI N: 0.671 15A FE2 Bisphosphonates CharacteristicsCrew Time SubjectsExperiment ISSMP Expedition 18 Inflight Experiments Midodrine Nominal time for ECG session/ Pill Ingestion prior to return on flight ULF2; Reserve time for photo ECG session will provide Go/NoGo decision for pill ingestion after TIG N: 1.17 R: 0.08 1 1J FE2

11. 11 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer ISSMP Expedition 18 Inflight Experiments CharacteristicsCrew Time SubjectsExperiment Integrated Immune 5 1J FE2 CDR ULF2FE2 15A FE2 18S FE1 N: 12.50 R: 0.75 Blood & Saliva Collections performed in conjunction with a vehicle docking: CDR: Early-16S, Mid-15A, Late- 17S ULF2 FE2: Early-ULF2, Late-15A 15A FE2: Early-15A, Mid-17S ‏ 18S FE1: Early-17S STS Crewmember will assist as blood draw operator as close as possible to hatch closure Post-undock blood draws performed with SDBI subjects. Blood/Saliva stowed at ambient temps Reserve time is P/TV

12. 12 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer CharacteristicsCrew Time SubjectsExperiment ISSMP Expedition 18 Inflight Experiments CCISS Journals N: 4.50 R: 14.42 2 1J FE2 CDR 2 CDR ULF2 FE2 R: 15.00 Reserve payload time represents: 18 CDR: early & late sessions ULF2 FE2: early & late session Holter Monitor 2 will replace Holter Monitor for ULF2 FE2 sessions and CDR’s late session ppm1all0122 secured 5 min, timelined reminder for 1J FE2 prior to Sleep Nominal payload time will represent 18 CDR: ~6 weeks of entries,1 mid-increment questionnaire Pursue task list implementation if hard scheduling cannot be accommodated for completion of Reserve activity

13. 13 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer CharacteristicsCrew Time SubjectsExperiment ISSMP Expedition 18 Inflight Experiments HRF Facility Ops Rack1 Rack2 Sleep Long N: 0.75 R: 19.67 5 1J FE2 CDR ULF2 FE2 15A 18S FE1 N: 0.25 R: 3.17 N: 0.42 R: 2.00 Nominal time for both racks includes the UltraBay Change-outs for ULF2 Load Rack 2 includes a nominal IP Address Reset activity Reserve time includes hardware Checkouts/Health Checks that may be fulfilled by other science activities Nominal time carried for 1JFE2 Doff 18SFE1 Init/Don CDR Don (URC ECR comment) Reserve time includes downloads and Sleep logging (on SSC) Pursue task list implementation if hard scheduling cannot be accommodated

14. 14 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer Dnld/Dnlk Int Immune Sal/Blood October Soyuz / Shuttle 15A Nutrition/ Repos/Bisph HRF Facility 17S 16S Inc. 18  18S Inc. 19  Description NovemberDecemberJanuaryFebruaryMarchApril HST31PULF232P FD15FD30/ FD15 FD15/ FD 120 FD60/ FD30 FD180/ FD60 CCISS R- 14-21L+14-21 Green = CDR Black =FE2/1 Prple = Untended Blue shading = Nominal Gray shading = Reserve Checkered shading = Docked Ops ECG Session Midodrine 1J Doff Journals Mid-Inc Quest Log SLEEP Dnld/Dnlk18S FE1 Init/Don Dnld/ Dnlk 1J FE2 Dnld/Dnlk Don 1J FE2 Jrnls-TL STS Bld Draw Sal/Blood STS Bld Draw Sal/Blood L+14-21R- 14-21 FD60 FD120 FD120 FD30 Braslet HM2 C/O ULF2 Load PC1- PC2 UltraBay Chg-O CPBD C/O Braslet Pill Ingest Don/Doff Don Dnld/Dnlk Log GASMAP CDR Jrnls- 3x/wkCDR Jrnls on Task List Dnld/Dnlk Doff GASMAP

15. 15 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer ISSMP Crew Time Break-out

16. 16 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer Inc 18 Issues/Risks Identify possible implementation of reserve activities via Task List and/or Voluntary Science (CCISS/Journals/Sleep) Determine ULF2 Load impacts to procedures and submit updates to execution notes/procedures via OCR Holter Monitor 2 (arriving on ULF2) will replace Holter Monitor for CCISS activities  ULF2 FE2 first CCISS session window = FD+14 days through FD+21 days  If ULF2 PC Load and Holter Monitor 2 Checkout are not accomplished prior to ULF2 FE2 first CCISS Session, a work-around will be identified via an OCR to utilize Holter Monitor 2

17. 17 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer ISSMP Forward Work - Internal Baseline new procedures:  Holter Monitor 2 Check-out  Bisphosphonates Pill Ingestion/Urine Collection CEF/OCRs defining:  17S SFP Activity support for Soyuz docked ops  HGD/PFD Checkout will be removed from Inc 18 Submit new CCISS with Holter Monitor 2 procedures via OCR Submit Subject Data OCA Messages for CCISS/Sleep via OCR Submit HRF PC1 Reconfiguration Plan on SUP via OCR Updates reflecting the ULF2 PC Load via OCR Confirm Braslet JOIP established Update POH SOP 4.7 OCA Downlink Process to include directory listing for deletion confirmation step Forward Work - External

18. 18 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer Back Up Slides

19. 19 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer Increment 17 Applicable Open PARs

20. 20 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer Objective: To Develop and validate methodology to assess the circulating volume changes and cardiac function in spaceflight conditions, through short- term hemodynamic modification using Braslet-M occlusion cuff Impact to communication (2) 25 minute periods of continuous privatized KU- and privatized S-band coverage Impact to consumables Imaging Gel, Cardiac Electrodes, Wipes and Drinking Straws Impact to crew time Experienced ultrasound operator and minimum of 5 subjects (self scan of operator a possibility) SDTO 17011-U/R Validation of On-Orbit Methodology for the Assessment of Cardiac Function and Changes in the Circulating Volume Using Ultrasound and “Braslet-M” Occlusion Cuffs

21. 21 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer Bisphosphonates as a Countermeasure to Space Flight Induced Bone Loss Adrian LeBlanc, Ph.D. and Toshio Matsumoto, M.D., Ph.D. Category: Pre/In/Postflight (ISS crews) Previous Missions: Flight Activity : 15A FE2 Description: The purpose of this investigation is to determine whether bisphosphonates (either oral alendronate taken weekly throughout flight or IV zoledronic acid administered once preflight), in conjunction with the routine in-flight exercise program, will protect ISS crewmembers from the regional decreases in bone mineral density documented on previous ISS flights. Subjects Required: 10 Long BDC/On-Orbit Ops: BDC: Before and after flight, all subjects will complete DXA and peripheral (limb) QCT Scans (L-360, L-45, R+5, R+180, R+360, R+720 & R+1080), high resolution QCT scans (L-45, R+5, & R+360), blood draws with 24-hr urine collections (L- 30, L-10, R+0, R+14, R+30, & R+180), and ultrasound imaging for assessment of renal stones (L-45 & R+30). Alendronate subjects will complete an Alendronate Tolerance Test on L-180, and they will take Alendronate on L-17, L-10, & L-3. Zoledronic Acid subjects will be administered the bisphosphonate on L-45 and will conduct one or more additional blood draws for post-infusion health monitoring. Baseline health status will be obtained for all subjects prior to preflight dosing with bisphosphonates. All subjects will begin Vitamin D and calcium supplementation as early as L-75. On-Orbit Ops: While in flight, Alendronate subjects will ingest a pill weekly. All subjects will conduct three 24 hr urine collection sessions (early, mid, and late-increment). Urine collections will be combined with those for Nutrition when crewmembers participate in both studies and session dates overlap. Diet and exercise logs will be obtained via data sharing. ISS On-Orbit Resource Requirements: Crewtime (HRP), Russian Segment (urine collection), Bar Code Reader, MELFI (for freezing of urine samples)

22. 22 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer HRF Ops Lead contacts the OC console via voice or E-mail and requests file(s) from the SSC “U” drive. The OC will write an Internal Flight Note to the OCA Officer documenting the request. The OCA Officer will downlink files and place them in the TSC secured “ftp” site & inform OC; OC will contact HRF Ops Lead. The HRF Ops Lead will inform the TSC personnel who in turn will transfer the desired file to their TSC secured VPN account for PI retrieval. HRF Ops Lead will confirm all files have been received by the PI and relay to OC After final file downlink and transfer HRF Ops Lead will relay to OC that all subject data has been retrieved/verified and the original file can be deleted. The OC will provide a directory listing to HRF Ops Lead from OCA Officer after the file deletion to confirm close-out of all actions.  Any ISSMP payload will be handled this way (e.g., Journals, Sleep Logs, etc). OCA Downlink Process (SOP 4.7)

23. 23 July 2008 POIWG #24 – Inc 18 Overview ISS Medical Project (ISSMP) S. Johnston/K. Spicer Acronyms & Abbreviations ANITA Analyzing Interferometer for Ambient Air BMEBioMedical Engineer CHeCSCrew Health Care Systems CCISSCardiovascular and Cerebrovascular Control On Return From ISS ECGElectrocardiogram EPASEarth to Orbit Vehicle Payload Activity Summary ESAEuropean Space Agency GASMAP Gas Analyzer System for Metabolic Analysis Physiology HRF Human Research Facility HRPHuman Research Program ICBInformed Consent Briefing ISSMP International Space Station Medical Project KSCKennedy Space Center MECMedical Equipment Computer NBSRNASA Biological Sample Repository OCROperational Change Request PCPersonal Computer PFE-OUMPulmonary Functional Evaluation – Oxygen Uptake Monitor PFSPulmonary Function System PMCPrivate Medical Conference RCRefrigerated Centrifuge SDBIShort Duration Bioastronautics Investigations SDTOStation Development Test Objective SSCStation Support Computer SSD Standard Stowage Drawer STSSpace Transportation System TIGTime of Ignition USNDUltrasound USOSUnited States On-orbit Segment